Rational and reliable diagnosis of periprosthetic hip and knee joint infection using two nuclear-medicine methods: 99mTc-ciprofloxacin and 99mTc-MDP scintigraphy

Background/Aim. There is a constant and dramatic in-crease in hip knee prosthetic implantations worldwide. However, decrease the percentage of failed (infected) not significant (0.5% up to 2%). The real challenge whether joint loosening was caused by aseptic inflammation or infection. aim present study attempt distinguish sterile from infection patients with painful joint. Another objective determine accuracy cumulative bone scintigraphy methylenediphosphonate (MDP) ciprofloxacin diagnosis periprosthetic (PJI). Methods. Three-phase 99mTc-MDP 99mTc-ciprofloxacin used. patient selection criterion for this suspicion PJI followed limited movement joint, accompanied elevated unspecific inflammatory factors. Forty five 39 implanted hips 24 prostheses were included evaluated. All joints examined (although some them asymptomatic) underwent plain radiography. An average time span between two nuclear medicine imaging procedures 3?5 days. performed first. Scintigraphy necessarily involved calculation accumulation index. obtained results confirmed microbiological findings as gold standard. Statistical analysis using SPSS version 20 software (descriptive statistics, ?2-test). Sensitivity, specificity, predictive values also calculated. Results. Microbiologically found 16 out prostheses. Positive 15 joints. knee, microbiologically con-firmed all 13 suspected Estimated sensitivity/specificity alone (for both joints) 90%/69%, it 93%/97%, 96.5%/97%. Conclusion. Cumulative increases ability differentiation PJI, high 97%.